Purpose
Matrix-induced autologous chondrocyte implantation (MACI) is a regenerative procedure aimed to recreate a hyaline-like repair tissue, restoring a biologically and biomechanically valid articular surface with durable clinical results. The purpose of this study is to assess patient reported outcome measures (PROMS) in a series of patients aged 40 to 55 to characterize and elucidate results when using the MACI graft in place of the previous ACI or CACI “sandwich” procedures.
Methods
A retrospective review of a prospective patient series was undertaken. The study population included patients aged 40 to 55 at time of surgery who underwent MACI procedures with minimum 6-month follow-up. The primary study endpoint was defined as an improvement of pain scores as measured at a minimum of 6M post-operative compared to preoperative value. Secondary endpoints included IKDC, KOOS, Lysholm, and SF-12 scores. All procedures were performed by the senior author, a fellowship-trained sports orthopaedic surgeon. Differences in mean outcomes were assessed using a generalized linear mixed model with a Poisson distribution and a random patient effect to account for correlations over time. All P-values were adjusted for multiple comparisons using the Tukey-Kramer method with alpha less than 0.05 considered statistically significant.
Results
11 patients with mean age 28.6 years underwent MACI for their chondral defect. Mean follow up was 22.0 months (range 8-51 months). 45.5% of patients had a single defect treated while 36.4% of patients had two lesions treated. Table 1 demonstrates PROM at measured intervals of pre-op, 6 months, 12 months, and 24 months post-op with corresponding statistical significance. Statistically significant improvements were noted at 24 months follow up in 7 of 10 outcome measures (Fig 1).
Conclusion
MACI has clinically significant results at 2-year post-operative follow up in improving patient reported outcome measures in patients aged 40 to 55.